Urban and Rural Variation in Fertility-related Behavior Among U.S. Women, 2011–2015

Questions for Kimberly Daniels, Ph.D., Statistician and Lead Author of “Urban and Rural Variation in Fertility-related Behavior Among U.S. Women, 2011–2015.”

Q: Why did you decide to examine fertility-related behavior among U.S. women in urban and rural areas?

KD: We decided to examine fertility-related behavior among U.S. women based on urban and rural residence because while there are many National Survey of Family Growth (NSFG) reports on fertility, they do not usually include information about place of residence.  Two NCHS reports were recently published that use Vital Statistics data from birth certificates and focus on urban and rural differences.

One of those reports was on urban and rural differences in infant mortality rates and the other on urban and rural differences in teen birth rates.  After seeing the differences shown in those reports, we decided to work on an NSFG report focusing on fertility-related behavior and place of residence.

Q: Are there any findings among the urban-rural differences that surprised you?

KD: As far as what findings in this report surprised me, based on other publications we reviewed before starting this report I expected that the percentage of currently married women would be higher in rural areas compared with urban areas.  The results in this report showed that the percentage of women who were currently married in each area was similar, around 40%.  I also expected that there would be a difference for cohabitation; although I am not sure which group I expected would be higher.

The results for age at first sexual intercourse may be surprising to readers of the report.  This report uses data from women ages 18-44.  Place of residence is measured at the time of interview.  Among adult women who have ever had sex, the average age at first sexual intercourse was lower for women living in rural areas, 16.6 years on average, compared with 17.4 for women living in urban areas.

Q: Do you have any older trend data to this report from the National Survey of Family Growth for urban and rural fertility-related behavior?

KD: As far as trends over time, we do not show trend data in this report on urban and rural variation in fertility-related behavior.  Some older NSFG reports do include that information, such as this one on fertility, family planning, and reproductive health using 2002 data.  The variable that classifies women as living in an urban or rural area is available on our public use datasets.  It is available to download from our website so researchers could examine time trends or differences in other topical areas by place of residence.

Q: What did your report find on contraceptive use among women in urban and rural areas?

KD: The report looked at contraceptive method use at last sexual intercourse among women ages 18-44 who had sex in the last 12 months.  Contraceptive methods were grouped into four categories based on effectiveness at preventing pregnancy; no method, a less effective method, a moderately effective method, and a most effective method.  The results showed that similar percentages of women in urban and rural areas used no method of contraception, 21.0%.  A higher percentage of women in urban areas used a less effective method, such as a condom, compared with women in rural areas.  A higher percentage of women in urban areas also used a moderately effective method, such as the oral contraceptive pill, compared with women in rural areas.  A higher percentage of women in rural areas used one of the most effective methods of contraception such as a sterilizing operation or an intrauterine device compared with women in urban areas.

As we note in the report, the percentages we show for contraceptive use and the other measures do not account for other factors that could play a role.  For example, the figure that describes differences in number of births shows that women in rural areas are more likely to have had any births and have a higher average number births.  So, some of the differences in contraceptive use across the two groups could be related to differences in plans for future childbearing.

Q: What is the take home message of this report?

KD: The takeaway messages are shown in the key findings and summary in the report.  Among women aged 18-44, on average, women living in rural areas had their first sexual intercourse at younger ages than women living in urban areas. Similar percentages of women in urban and rural areas were currently married, cohabiting, or never married. A higher percentage of women living in rural areas were formerly married compared with women in urban areas. Women living in rural areas were more likely than women living in urban areas to have had any births and had a higher average number of births. Among women aged 18–44 who had sexual intercourse in the past year, a higher percentage of women living in rural areas used one of the most effective methods of contraception at their last intercourse compared with women in urban areas.  It is important to remember that place of residence was measured at the time of interview.

Some of the outcomes in the report occurred when the woman lived in another geographic location.  Also, as I mentioned above the results do not account for other factors that could play a role in the urban and rural differences presented in the